Pyelonephritis paturopi. Pyelonephritis: te maimoatanga (taero)

Ko tētahi o te pyelonephritis mate tākihi tino noa whakaaro te. Ko te māuiuitanga Ko te tukanga whānui. Mumura ngā papatoiake tākihi me te kapu, a ka he huinga (interstitial) kiko. puta mate rānei waho i roto i te pūnaha mimi huarahi hematogenous ranei (i roto i te bloodstream) i te tahi atu urutā. I tua atu tātari rite pyelonephritis whakaaturia. Treatment, taka hoki ano ka whakaahuatia tona whakakorenga i roto i te tuhinga.

Overview

E whakaaro ana te tukumate matua pyelonephritis rōpū staphylococci huakita, Escherichia ko Pseudomonas aeruginosa, Proteus, streptococci, enterococci. He nui iti pea ki kua kite te whanaketanga o te māuiuitanga kitea ki harore huaketo ranei. Kei te maha pyelonephritis pōreareatanga e rōpū tukumate koiora L-puka ranei. rerekē te whakamutunga āhua urutau anga-iti āhuatanga e ātete tiketike ki ngā rongoā. Tenei hanga te reira e kore e uaua maimoatanga anake, engari ano hoki ki te tātari mate. tino hohoro te mate riro i te koi ki te atamira ma'i. Na reira, paturopi hoki pyelonephritis tākihi kia whakaritea rite wawe tonu.

mehua haumanu

kia whai tetahi paturopi i roto i te pyelonephritis te whānui o te mahi whakaora, mahi bactericidal tiketike, nephrotoxicity iti. kia excreted hoki rongoā i roto i te mimi i roto i te moni nui. Ko te rārangi o paturopi e kua whakaritea i roto i te māuiuitanga whakaahuatia ngā aminopenicillin pare penicillins, cephalosporins, karboksipenitsilliny, aminoglycosides, fluoroquinolones. Next, whakaaro he aha paturopi e tino maha whakaritea hoki pyelonephritis.

aminopenicillin

Kei te ngana tohunga inaianei ki kore whakaritea enei raau taero i roto i te pyelonephritis. E āhuatanga ratou i te mahi tūturu tiketike ki Proteus, E. coli, enterococci. whakaaro ratou drawback matua te ki kia pāngia e te rongo ki te beta-lactamases - whākōkī whakaputaina e te momo o tukumate hauora e hāngai ana. I teie mahana e kore e enei paturopi i te mumura o te whatukuhu tūtohutia (anake māuiuitanga o te hapūtanga) no te mea o te nui haere ngā taumata o ātete (ātete) taumahatanga o E. coli (30%) taua.

penicillins tiakina

E whakaaro ēnei paturopi mō pauku tikanga kōwhiringa. whakaatu Medicaments mahi nui microorganisms āhua kino e hua i te beta-lactamase, me te huakita karamu-pai, tae atu rongoā paturopi-ātete, me te coagulase-tōraro staphylococci. Ko te taumata o te pūmautanga, i tiaki taumahatanga whakaatu o coli Escherichia ki penicillins, he āhua iti. maha whakaritea paturopi mō pyelonephritis "Amoxicillin" me te tikanga "clavulanate". Ana tēnei huinga e tūtohu roto 625 mg / 3 p. / Day. ranei parenterally i 1.2 g / 3 p. / ra. Duration o te maimoatanga - i whitu ki te tekau nga ra. whakaaro puka auaha o mea huinga paturopi te i roto i te pyelonephritis "Flemoklav Soljutab". Kua kï te tarukino tōtika ki mate mimi. Tikanga "Flemoklav Soljutab" whakaaetia te hoki te whakamahi i roto i ngā tūroro ki te toru marama hapu.

Rongoā i roto i te puka uaua

I roto i ngā take kino, a i roto i te wā o te mate whakapae whakapataritari e Pseudomonas aeruginosa, kia whakaritea ai karboksipenitsilliny. I roto i ngā, he reira he paturopi taua i roto i pyelonephritis, rite "ticarcillin". I roto i te rōpū kotahi, ka ko reira he tikanga o "Carbenicillin". I tua atu karboksipenitsillinov kia kia ureidopenitsilliny tūtohutia. Ēnei ngā taero pērā i "azlocillin", "Piperacillin". Me kï hoki, Heoi, e kore e tūtohu te penicillins pseudomonas rite monosredstva. Ko e tika ana ki te tūponotanga tiketike o te ātete koiora ki a ratou i roto i te akoranga o te therapy tenei. I roto i te maimoatanga o te pyelonephritis whakamahia ngā o enei taero me inhibitors beta-lactamase. I roto i ngā, i te huinga whakaritea o te tikanga e whai ake nei: "ticarcillin" + waikawa Clavulanic, "tazobactam" + "piperacillin". Hoki e whakamahia ana he ngaahi kautaha antipseudomonal paturopi fluoroquinolones me aminoglycosides. E whakaritea taua medicaments, a i roto i te kino pathologies hopuhopu nosocomial o te pūnaha mimi.

cephalosporins

Enei taero i te kaha ki te whakaemi i te parenchyma tākihi me te mimi i roto i te kukū makona tiketike. rerekē cephalosporins nephrotoxicity āhua. Ko ēnei rongoā i runga i te wahi tino i teie mahana i te auautanga ūnga i roto i tūroro ki pyelonephritis me mate roma mimi. He maha ngā whakatupuranga o cephalosporins. E wehea ratou rite ki te whānuitanga o ngā mahi, me te tohu o te ātete ki te beta-lactamases:

• whakatupuranga 1. Teie mau faaineineraa i te āhua iti hihinga o mahi. mahi ratou preferentially i cocci Gram-pai, me te pathological akoranga whakapeka kore hāngai.
• whakatupuranga 2. Ēnei cephalosporins i te whānuitanga whānui o te mahi. He kaha ratou ki te whakapai kanohi ki E. coli me etahi atu Enterobacteriaceae. Hoki raau taero i roto i tenei rōpū ngā, hei tauira, te tikanga o "Cefuroxime."
• whakatupuranga 3. Cephalosporins o tenei rōpū e whakamahia i roto i te mate uaua. Rongoā whakaritea rite roto (te tikanga "ceftibuten," "Cefixime"), me te parenterally (taero "Ceftriaxone", "cefotaxime"). I roto i te take whakamutunga te āhuatanga ko te roa hawhe-te ora, me te whakamahi o te rua ara ki te tango i te tinana: te mimi me te ate. I roto i te rōpū o te toru-whakatupuranga cephalosporins rongoā reira, whakaahua mahi ki Pseudomonas aeruginosa. Tenei, i roto i ngā, te tikanga pērā i "Cefoperazone" "Ceftazidime" me te faaineineraa ingibitorzaschischenny "Cefoperazone" + "Sulbactam".
• whakatupuranga 4. Cephalosporins o tenei rōpū i nga āhuatanga katoa o raau taero o te kāwai o mua, engari he ratou ake kaha ki cocci Gram-pai.

aminoglycosides

E tūtohutia ēnei rongoā i roto i ngā uaua o te pyelonephritis, me te tino mate nosocomial. Ko te rōpū o aminoglycosides ngā taua tikanga rite "Amikacin," "Tobramycin", "netilmicin", "gentamicin." I roto i ngā take kino, e ngā enei taero ki cephalosporins me penicillins. Kei te ruarua whenumi Aminoglycosides i te wahi gastrointestinal. I roto i tenei whakaaro, ka kia whakahaerea e ratou pai parenterally. kawea excretion o taero i roto tonu i roto i te mimi. Hoki tūroro ki täkihi he tika ki te whakatika i te inenga. 'Oku totonu ke kau nga āhuatanga o aminoglycosides ratou nephrotoxicity korerotia me ototoxicity. auau mate rongo i roto i tūroro ki runga ki te 8%, me te kino tākihi (whakakitea rite neoliguricheskoy kore te tikanga reversible) - 17%. hanga tenei reira e tika ana ki te whakarato i maimoatanga i roto i te mana tukanga o te taumata o te Urea, pāhare pāporo, creatinine. No te mea te faaiteraa o te fakafalala o pōauautanga o te kukū i roto i medicaments toto whakamahia whakahaere kotahi katoa inenga ia. he kaupapa taua, i roto i era atu mea, tauturu ki te whakaiti i te tūponotanga o te whakawhanake nephrotoxicity. Ko te āhuatanga o te takanga o pōauautanga ngā:

• te whakamahi toutou o te tarukino ki te whati o te iti iho i te tau.
• koroheketanga.
• maimoatanga wā-roa ki te Diuretics.
• tono Matatini ki nga tikanga o te rōpū o cephalosporins i roto i toketaá tiketike.

fluoroquinolones

Enei rongoā e, i roto i nga tau tata nei i te maimoatanga o te whiriwhiri. E whakaritea ratou i roto i ngā tautuhinga tūroro me te tūroro noho. Hoki te tuatahi-whakatupuranga fluoroquinolones ngā taero pērā i "Ciprofloxacin", "pefloxacin," "Ofloxacin". He mātātoa ki te nuinga o tukumate i roto i te pūnaha urogenital ratou. Ko te painga o taero ko ratou te tāoke iti, roa hawhe-te ora, e i roto i te tahuri, ka taea ki a koe te tango i a ratou rua he ra. Fluoroquinolones pai faatia puka i roto i te mimi, tākihi kikokiko, toto kukū feunga tiketike. Medicines tono parenterally e rua, me te roto, engari te tikanga "Norfloxacin" (te tikanga reira mo te whakahaere-waha). te tuarua whakatupuranga fluoroquinolones (taero "lomefloxacin", "Levofloxacin", "Moxifloxacin", me ētahi atu) e ake kaha ki te faatura ki karamu-pai microorganisms, rawa pneumococci. I te wa ano i te taua rite te whakatupuranga o mua o taero, mahi kaha i runga i huakita karamu-kino (anake Pseudomonas aeruginosa) ratou.

prophylaxis o pyelonephritis

I roto i te tikanga ki te karo matahoki tuatahi ranei o te māuiuitanga he tika ki te whakakore pāngia e teu katoa. Prophylaxis o pyelonephritis ngā te whānuitanga o ngā mehua. Tenei i taea e ngā te māori o kai, mahi me te okiokinga, moe me te 'ā'ā. He huru tika ko te whakarerenga tino o te hauhauaitu. kia utua ngā whakarongo ki te āhua whānui o te tinana - he mea nui kia reira ko kahore mate. I roto i tenei hononga, kia waiho reira taea ki te whakahaere therapy o mate: colitis, caries, gastritis me etahi atu.